Health care a right or privilege
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This is a current discussion topic for a masters class. Is health care a right or privilege? What do you think? What do you think about the Affordable Care Act? Do we need universal health care? The... Read More

Apr 6, '12

We don't have health care rationing now???

Really?

Does anyone really think that the indigent in heart failure needing a new heart gets the same care as a former elected official?
Do we really think that the medicaid patient requiring a new liver gets the same opportunity at transplant as the rich and famous actor who drinks too much?
Honestly, does the poor woman get the same access to prenatal care and OB services as the wealthy woman?
Does that woman even have the same access to family planning, oral contraceptives, or other preventative health care?

To ration something is to establish a fixed portion...do we really think that this is not happening, as we speak, in our current health care model???

I would love Universal health care. I could retire! The only reason I'm working is to have health insurance. I love my dogs and I'd be out training every day and most weekends, I could be off running an AKC hunt-test or field trial. Wow. That would be great.

As long as you can PROMISE me there would be no rationing, I could have whatever doctor I want, and he and I could have any care, medicine or tests we thought was necessary. Excluding of course, cosmetic stuff.

Very honestly, I have two artificial knees. I don't know how long those things last. But if in 20 years I need to have new ones put in... I don't want anyone telling me I'm too old.

But for the non-US members here... we do have an obstacle in the form of our Constitution. If we are going to have Universal Health Care, it has to be able to pass Constitutional muster, and the way the Congress went about this Affordable Care Act was dubious on many fronts. A lot of smart people say that a truly Universal Care, with single payer, would be Constitutional. But politically, the Democrats did not think they could get it passed. So they came up with a hybrid approach that satisfies very few.

I honestly don't know what to say to that. Maybe it's just semantics but the concept of something being 'denied' is foreign to me. Things are done or not done based on need and clinical judgement, not based on age. A 95 year old is usually not the same as a 60 year old in terms of their general health, ability to withstand surgery, recovery time, and the likelihood of a successful outcome no matter what the procedure is. I would think that the average 95 year old would be unlikely to do all that well after a knee replacement so it would be a risk/benefit thing. That would be the same anywhere wouldn't it? There comes a point in everyone's life where the risks of certain surgeries or treatments outweigh the possible benefits. That doesn't mean that that surgery or treatment is being denied based on age. It's being denied because the patient would be worse off afterwards. If it was thought that the 95 year old would survive the surgery and their life would be improved by the knee replacement, I don't see why they wouldn't receive it.

In general terms, the government has an interest in keeping everyone as healthy as possible because that keeps costs down and people who are sick aren't productive although I'd like to think there's some altruism there too. The government would rather fund the knee replacement than a nursing home bed because the knee replacement is cheaper. The government would rather fund free annual mammograms and bowel cancer screening for those over 50 so that things can be caught while (hopefully) still with a good chance of cure. It would rather fund free whooping cough immunisation updates for new parents and grandparents in an attempt to prevent the current whooping cough outbreak from getting any worse. It would rather encourage people to manage their chronic illnesses by providing affordable and easy access to doctors and medications than have people presenting to the hospital for what can be managed in the community.

Our system is certainly not perfect but I'm glad to have it.

Apr 8, '12

I tap out, jmqphd. I can't debate with someone that is more stuck in 1955 than Marty McFly.

Apr 8, '12

I'm still stuck on the comparisons to the American public education system. We all get public education so we all should get healthcare? Have you seen our education system lately? Since public education was instituted, our education standards have been on a downhill slide. Nowadays, more money seems to go to paying the administrators than to educating our children. Program for music and the arts are being phased out for lack of funding, even when shown to improve our children's thinking skills, while the moneymaking sports are being expanded. Our local high schools can't afford assistant band directors, but the football team has 8+ coaches and asst coaches. Education itself is substandard, our children our only being taught to pass tests (because the schools lose government funding if enough of the "right" kids don't pass), and they're failing miserably when it comes to college because of that.

That's our government-run education system. Is that really what we want for our healthcare, as well?

Apr 9, '12

If we dismantled public education we run the very real risk that only those who could afford it would learn to read, write, and cipher. It would, in no way, benefit our country if the masses were uneducated and only the elite or wealthy could afford even basic schooling. Already, "public" college education is in danger of becoming (again) an expensive and unachievable goal for lower income youth. We certainly don't want that same paradigm applied to our K-12 students, IMHO.

I agree that our priorities need to be readjusted in the school system and we share the disdain for the imbalance of support when it comes to sports vs. other essential education like readin, writin, rithmatic, music, art, shop, etc.

Apr 9, '12

We already are running the risk, that only the rich, or those fortunate to work of companies who provide medical bebefits for employees, will have medical insurance. There is already that discrepancy.

Parents can home school their children, and provide them with a decent education.

You cannot provide the medical care most of us need in the same fashion.

Yes, there is waste in public education, but is there not equal waste in our hospitals? The fancy artwork and piano in the lobby, when there are insufficient nurses at the bedside? The plethora of hospital administration and management when nurses are run ragged from deliberate short staffing?

We can fund a Single Payer System for this country. Our elected leaders lack the incentive to do so.

JMHO and my Ny $0.02.

Lindarn, RN ,BSN, CCRN
Somewhere in the PACNW

Apr 14, '12

Mark my word...... rather its education, health care, energy, or any major life affecting aspect of life, to fix the problem you must first do one thing: GET THE FEDERAL GOVERNMENT OUT. I do not know the "solution" to the problems but booting the feds out of medicine altogether would get us off to a great start.

We already are running the risk, that only the rich, or those fortunate to work of companies who provide medical bebefits for employees, will have medical insurance. There is already that discrepancy.

Parents can home school their children, and provide them with a decent education.

You cannot provide the medical care most of us need in the same fashion.

Yes, there is waste in public education, but is there not equal waste in our hospitals? The fancy artwork and piano in the lobby, when there are insufficient nurses at the bedside? The plethora of hospital administration and management when nurses are run ragged from deliberate short staffing?

We can fund a Single Payer System for this country. Our elected leaders lack the incentive to do so.

JMHO and my Ny $0.02.

Lindarn, RN ,BSN, CCRN
Somewhere in the PACNW

I just participated in a femoral-popliteal bypass on a demented 88 year old! Those of you who take care of vascular surgery patients understand the level of patient participation required in the post-op period. We can assume that this kind of assault is going on thousands of time a day in this country. For those opposed to rationing: There can never be RATIONAL health care without RATIONING. Before we decide how to pay for it, let's stop paying for absurd care. This is going to be really, really rough but it HAS to be done. For the previous poster who worried that single-payor wouldn't pay for her future knee replacements; as long as you're using your knees, why wouldn't they pay. It would be irrational not to keep you moving and comfortable. Now, when the 400 pounder shows up for knee replacements, that's another story. Deal with the problem that's causing your crushed knees, get a gastric bypass, do what you have to do so that your knee replacements will last more than five years. Surgery and ICU is where the big bucks are being sucked into a black hole. I don't begrudge anyone primary care - it's humane AND cost-effective. The sticky wicket comes with big-buck expenditures with very little reward to anyone except the medical-industrial complex.

This is a current discussion topic for a masters class. Is health care a right or privilege? What do you think? What do you think about the Affordable Care Act? Do we need universal health care? The answers to these questions will be used during a debate in a Nursing Ethics and Policy course. Your input would be greatly appreciated.

Only in America do people think that health is something a privilege and not a right.

Shame.

We could learn something from Europe.

Apr 15, '12

Until the questions regarding poverty in the United States are settled, healthcare will continue to be a battle ground.

Many other countries such as Western Europe and the UK believe there is a "floor" by which no one in society should fall below. To this end governments tax and spend to provide for a society that a majority of persons want.

In the United States OTHO poverty is seen as some sort of disease and or the direct result of one's own inability to do better. This fits right in with the Protestant ethic brought to these shores from the first English settlers; hard work is one's salvation, therefore if one is poor then obviously you didn't work "hard" enough.

Every where you look in this country it is divided by those who have and those that do not, and healthcare is no different. You are going to have a very hard fight on your hands if you try telling those who can afford the best healthcare that they either cannot access it, or should be required to pay more than they already do in order for others to have the same.

Just look around, hospitals and other facilities that mainly provide charity care are dropping like flies. The great Catholic heathcare systems such as Saint Vincent's in NYC are vanishing or having to morph into something else in order to survive.

Only in America do people think that health is something a privilege and not a right.

Shame.

We could learn something from Europe.

I'm as baffled as anyone else if healthcare should be a pure "right" and what the consequences of that logic are (be careful what you with for!). Europe is broke and experiences extensive rationing. So, as a result, they have a two tiered system where the wealthy have lots of (maybe excessive) "care" and the proles get the basics but no frills. Sloan-Kettering in New York gets a big portion of its business from foreigners. I tend of thing of health-care as a right but then it gets sticky. Right to what? A previous poster wants to be able to pick all her doctors and dictate what tests she should receive. Should a 90 year old get a CABG?. Should a 20 week fetus be resuscitated? The list is endless. Should the wealthy be able to buy their way out of the government policy? Who does that leave to take care of us proles?

Only in America do people think that health is something a privilege and not a right.

Shame.

We could learn something from Europe.

Health and health CARE are two entirely different things.

Apr 17, '12

Whilst still in the frame of mind to rattle a few cages I think the idea iof the Trickle down theory of giving tax breaks to the wealthy leads to economic growth has been totally debunked , at the moment taxation of the wealthy is not at historical highs yet the stream of investment is like that of an old man with an enlarged prostate .

I know some will say its their money , but where did it come from ?it came from us who bought the product or service .

I think we should have a percolate up economy , one in which we all share in the benefits of the profits produced ,then pay the same levels of taxation upon ALL forms of income .

The present taxation regime is simply a means to maintain the incomes of the wealthy during a declining economy at the expense of the middle class , some of whom feel more inclined to worry about the distractions of what is happening in others bedrooms , than keeping their eye upon what is best for their own pocket book .